Borderline hyper thyroidism

[Emerald1953]

hello

Apparently I have Borderline hyperthyroidism GP has suggested I see an endocrinologist would appreciate it. If someone has the same. Could you share your symptoms please Thanking you in advance

[greygoose]

Hi Emerald1953, welcome to the forum.

I think you might get more response from people if you posted the actual numbers: results and ranges.

I think quite a few people get 'diagnosed' with Borderline hyperthyroidism, which is meaningles, and doubt if such a thing actually exists. It all depends what was tested and what time of day the blood was taken, and your doctor's definition of 'hyperthyroid'. And quite a few other things. But we can't tell whats really going on without the blood test results and ranges.

[Emerald1953 in reply to greygoose]

Hi, GP is speaking to an endocrinologist next week, to see if I need checking out by them. I’ll check out my results and ranges and post back. Reading some posts your all so very knowledgeable, it’s all very complicated to me at the moment, but after reading the symptoms a lot apply to me, and I realise it might not be a thyroid problem. Thanks for replying.

[Emerald1953 in reply to greygoose]

By the way, it’s subclinical hyperthyroidism

[greygoose in reply to Emerald1953]

Subclinical/borderline, means pretty much the same thing - probably means that you have a low TSH, that's all.

What time was the blood draw for the results that have prompted this?

[Emerald1953 in reply to greygoose]

hi me again,

Are these any help?

Plasma TSH Level 0.21 mu/L

Serum free T4 level 23.5 pmol/L

[greygoose in reply to Emerald1953]

Well, that TSH is far from being hyper! 🤣🤣🤣 If you were hyper, it would be undetectable.

The FT4 looks high - although impossible to tell without the range - but your TSH wouls suggest it is. But not high enough to be hyper - subclincal or otherwise! Can you give me the range, please?

Have you ever had a diagnosis of hypothyroidism?

Are you on thyroid hormone replacement - levo, T3, NDT?

Have you had any antibodies tested?

What time was the blood draw for this test?

[Emerald1953 in reply to greygoose]

Hi

That’s all the information I have 🫤 I got those from my patient access app, it did show a chart, but I couldn’t understand it.

Bloods were taken at 2.15 afternoon

Glad I made you chuckle 🤣

[greygoose in reply to Emerald1953]

Ah ok! Well, TSH is naturally low at that time. Had you had the blood draw just before 9 am, as we always recommend, it would have been higher. Honestly, these doctors are so dumb!

And it was your doctor I was laughing at. They get into such a panic when they see a low TSH because they don't understand what it is or what it does.

Well, I think that should be your next step, get your antibodies tested. Problem is that your GP can only test one: TPO antibodies. But, that would do for a start.

[Emerald1953 in reply to greygoose]

Is it imperative I have an antibody test?

Thanks for the info

[greygoose in reply to Emerald1953]

If you want an explanation for the high FT4, and educate your doctor, yes. Levels don't go that high for no reason. But your GP thinks it's because you're sort of hyper, without really understanding what he means by that. GPs know next to nothing about thyroid. It would be good for him to learn!

But, if your antibodies are positive, it means you have Hashi's - aka Autoimmune Thyroiditis - which is a disease where the immune system slowly destroys the thyroid, making you more and more hypothyroid, with all that entails. You need to know. Because it's not going to go away. And, that high FT4 does rather suggest that that is what you have. You need to know for sure.

[Emerald1953 in reply to greygoose]

not on thyroid meds not had antibody test, originally went to GP with gastro issue, hence blood tests. Sorry not very techy either, as you can tell….☺️🤷‍♀️

[Confused01 in reply to Emerald1953]

Hi.

Absolutely need to get full bloods as the very knowledgeable other replies. Need a 100% full picture.

GP’s have such little knowledge generally in the endocrine field. At least yours is offering to see a consultant but if contacting one first you may find referral is held back until other bloods are done.

I’d say first stop is asking gp for all the bloods PurpleNails has mentioned below. Sometimes gp’s order bloods that then the lab that tests the samples declines to complete (usually the expensive bloods..crazy eh).

X

[Emerald1953 in reply to Confused01]

Hi 👋, I had all bloods done, all normal but iron was up a touch, thyroid came back abnormal.

Thanks for your reply.

[Kevz3016 in reply to Emerald1953]

Looks like your getting bombarded with info, your levels look ok. I'm Hypothyroidism and medicated and only feel better when my TSH is near to 0/suppressed like yours. It's all based on how you feel really. Good luck 🤞

[Emerald1953 in reply to Kevz3016]

Thank you Kevz. I had other bloods too, all are normal iron is up a tad, and of course thyroid said abnormal

Doesn’t help when one is a mega worrier 🫤

[PurpleNails Administrator]

Welcome to forum.

There’s many varied symptoms which occur for thyroid issues & there’s also quite an overlap with hyper (over active) & hypo under active.

GPs don’t always complete a full thyroid function test and sometimes initial results indicate hyper but it is transient or the TSH (pituitary hormone) is low which usually means thyroid levels are high - but they are also low.

This is complete list of hyper symptoms

thyroiduk.org/signs-and-sym...

I had I hyper nodule it cause mild Palpitations, Increased appetite, weight gain (opposing of norm). Low energy, dry eyes, itchy skin. Anxiety around driving car. Higher occurrences of migraines. Wasn’t all connected until much later. & doctors still say not all related.

I had a thyroid swelling 1 side which was investigated & cleared. The right tests hadn’t come back. I went back because my fingernails began detaching.

Obtain a print out via reception of any blood tests you have had or arrange online access with your GP surgery. Don’t accept verbal or hand scribbled notes you need a copy with ranges (ranges vary between labs). They shouldn’t ask why but if they do just say for your records.

TSH

FT4

FT3

Folate

Ferritin

Vitamin D

B12

First step is to find out why you are hyper & is it transient or continuous. Thyroid antibody will help with this.

TPO - Thyroid Peroxidase

TG ab - Thyroglobulin

These can be positive with autoimmune thyroiditis & Graves.

If Graves suspected important to test

TSI Thyroid Stimulating Immunoglobulin

TRab TSH receptor antibodies

[Emerald1953 in reply to PurpleNails]

Thank you

[Forestgarden in reply to Emerald1953]

When my ft4 is at about your level I feel extremely anxious, mind zipping about constantly, unable to focus, palpitations. Also get tremors, exhaustion and stomach issues. The symptoms list will tell you that hypos get constipation and hypers get diarrhoea - not me! I get constipation either way. As PurpleNails says there is a lot of overlap between hyper and hypo symptoms so you need full blood tests to figure out what is going on.

[SlowDragon Administrator]

Gut issues extremely common with autoimmune hypothyroid disease also called Hashimoto’s

Hashimoto’s frequently starts with transient hyperthyroid results before becoming increasingly hypothyroid

ALWAYS test thyroid early morning

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once for Hashimoto’s

Trab or TSI antibodies for Graves’ disease- autoimmune hyperthyroid

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

Low vitamin levels are much more common as we get older

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[Emerald1953 in reply to SlowDragon]

Whoa ! That’s a lot to take in 🤦‍♀️ especially when feeling a bit foggy brained too 🫤, looks like a private blood test is the answer. Should I mention all,of this to my GP when she calls me back after she has consulted endocrinologist? Thanks SlowDragon 👍

[SlowDragon Administrator in reply to Emerald1953]

find out which antibodies have been tested (if any)

You need TSI or Trab tested to confirm Graves’ disease, genuine hyperthyroid disease

TPO and TG antibodies tested for Hashimoto’s (usually just called autoimmune hypothyroid in U.K.)

Mildly raised TPO or TG antibodies can be present with Graves’ disease too

[SlowDragon Administrator in reply to Emerald1953]

The TSH and Ft4 tests are definitely not conclusive for Graves’ disease

You need further tests

Also Vitamin D, folate, B12 and ferritin tested

[Emerald1953 in reply to SlowDragon]

Hi

All this information that you have all so kindly shared with me is much too confusing for me, I’m just going to have to go along with what my GP suggests, and the endocrinologist, if I need to see one.

Thank you

[Emerald1953 in reply to SlowDragon]

Hi

Would this test be any use for me to take?

Good

[SlowDragon Administrator in reply to Emerald1953]

far better to use this one that INCLUDES vitamin levels too and is cheaper as well

And get a 10% discount using code THYROIDUK10

medichecks.com/products/adv...

[Emerald1953 in reply to SlowDragon]

Thank you, I’ll be seriously considering buying this.

[SlowDragon Administrator in reply to Emerald1953]

Thousands of members test privately

examples of Medichecks results

healthunlocked.com/search/p...

[Emerald1953 in reply to SlowDragon]

also….is it best to take the blood test early morning? fasting? about 9.o’clock….am I right ? Thanks again

[SlowDragon Administrator in reply to Emerald1953]

Yes

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

[Singwell]

Goodness, aren't you lucky in your GP! I'll share my story in case you resonate with any of it.I was borderline hypothyroid for years (maybe 10?), the dangers not explained and simply offered medication, which I refused because I didn't feel 'too bad'. I now know many of the symptoms I was feeling- and putting down to ageing (I'm 67) - were in fact hypothyroidism.

These were: difficulty getting going in the mornings, bouts of feeling cold, poor body temperature control generally, depression and anxiety. Because I didn't put on weight and have never really been overweight and because I had no head hair loss I felt the subclinical hypothyroidism wasn't a problem. I put the depression and anxiety down to personality and psychological background.

After about 7 years subclinical levels, I developed heart Arrhythmia. Later I found this can be a knock on effect of hypothyroidism. My cardiologist encouraged me to get my thyroid health attended to. And I'm so glad I did. I'm happier, have more energy, can face the mornings, am much less anxious and only feel low if I don't sleep well. I'm.still prone to heart arrhythmia but that's a done deal and I feel I can get on with and enjoy life again.

[Emerald1953 in reply to Singwell]

Hi 👋

Mine is hyperthyroidism, yours is hypothyroidism….I have the same symptoms as you described, how’s that so…? I put my symptoms down to age, and stressful situations on and off and unfortunately having “ the worry gene” 🫤🤷‍♀️ great hear your now feeling so much better, waiting for the day when I will too 🙏🏻 thank you for your reply 😊

[Singwell in reply to Emerald1953]

OMG how did I miss that? Must've been brain fog 😉. The others here will tell you high heart rates are linked with both hypo and hyperthyroidism. I'm not sure about the anxiety mechanism with hyper but I'd think it is because the rest and digest system is affected in some way. Plus anything to do with the heart can trigger anxiety. Do go and see that endocrinologist and get the info you need.

[Emerald1953 in reply to Singwell]

😃 no problem

My GP said she’ll have a word with endocrinologist, she hasn’t exactly referred me, but I must tell her exactly how I feel when she calls me back.

Thanks again 🌻

[Littlefoot1thyroiduk]

Been following the replies. I have Graves Disease , hyperthyroidism....confirmed with antibody tests and all the others advised on here.

. My symptoms- feeling I could not cope, tearful, mega tired, 5 days bed bound , lost stone & half in weight in a few months without trying , always hungry, itchy hurting eyes , palpations, and not realised at the time by anyone ( although my sister commented a month before - she hadn't seen me for a long while so clearly spotted a difference while it had crept up gradually on me ) until I did see the Endo , a goitre. ...swollen thyroid ....

My GP has been great at getting me monthly bloods of TSH Free T3 and Free T4..I do religiously now at 7am fasting . But I did pay to get the antibody test and thyroid scan to see if had any nodules, etc,

I copied the test results to the Endo and my GP.

I found the first 6 mths after the first flag there was something wrong stressful...just adding to everything else....( I was diagnosed with silent acid reflux a month before) ....

10mths on I am working full time again..long hours ..., on daily meds, but I do have to pace myself more than I ever have had to including getting to bed earlier. If I don't, I feel urghh and it takes me several days to recover.

So do get those test results....it took my stress away when I knew what I was dealing with...a few months more to come to terms with...and change my life style......I sm one of those type A types....so going slow while my body was on hyperdrive was a mind bender..against my character!

Good luck. If not happy keep asking and telling medics.

[Kapuna]

What made your doctor think you are borderline hyperthyroid? Was it a test? If not, it’s time you asked for at least three tests to be done, including the TSH, T4, and T3. They should give you a better idea. If just the TSH test was as done, ask for the other two. Also, find out if any family members have thyroid issues. There are genetic markers that can cause the TSH to be problematic when used by itself to diagnose hypothyroidism and hyperthyroidism.